Darrah A Wagner, LCSW,RN

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LC8702 Issued in ME

Practice address

29 Franklin St
Bangor, ME 04401-4909

Phone

(207) 942-3816

Fax

(207) 561-4725

NPI assigned

Jun 9, 2006

Last updated

May 4, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Acadia Healthcare, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bangor, ME
  • NPI 1568477297
  NPD (past)
• Knada, PA

  dba Behavioral Health Center

  • Clinical Social Worker
  • Bangor, ME
  • NPI 1841795127
  NPD (past)
• Northeast Occupational Exchange, Inc

  • Psychologist
  • Bangor, ME
  • NPI 1427002138

  Social Worker

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304467200000",
    "number": "1427099688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 FRANKLIN ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014909",
            "telephone_number": "207-942-3816",
            "fax_number": "207-561-4725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 FRANKLIN ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014909",
            "telephone_number": "207-942-3816",
            "fax_number": "207-561-4725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "DARRAH",
        "middle_name": "A",
        "credential": "LCSW,RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2011-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ME",
            "license": "LC8702",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "ME",
            "license": "R026710",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM LEGACY - LCSW",
            "identifier": "098304",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431984999",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alisa Mae Vroman, CRNA, CANP
• Algis Vydas, M.D.
• W W Wibby DDS PA
• Wabanaki Public Health and Wellness
• Brad Edward Waddell, M.D.
• Barbara Jean Wais
• Ann B. Waitt, PNP
• Victoria Wakana, MS, RD, LD
• Linda Keil Wakely, PH.D.
• Wal-Mart Stores East LP (Walmart Pharmacy 10-1856)

• Social Worker in Bangor, ME
• Providers in Bangor, ME by specialty
• Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.